Antidepressant Jeopardy Flashcards
Fluoxetine
prozac
SSRI
half-life is 1 week
Discontinuation syndrome
abruptly stopping SSRI with short t1/2
Serotonin Syndrome
HIGH risk if use SSRIs + MAOIs
Paroxetine
paxil
SSRI
AE - weight gain
short T1/2
tapered to be discontinued
washout period from MAOI to SSRI
2 weeks
escitalopram
lexapro
SSRI
S-enantiomer of citalopram
Fluvoxamine
luvox
SSRI
short T1/2
tapered to be discontinued
SSRI AE
sexual side effect (specifically ask)
desvenlfaxine
pristiq
SNRI
psychoactive metabolite of another SNRI
venlafaxine
effexor
SNRI
(any dose blocks serotonin reuptake)
at HIGH dose (>375mg/d) books DOPAMINE reuptake
dose dependent
AE - sweating, INC BP
TX perimenopausal women x hot flashes/flushes
Duloxetine
cymbalta
SNRI
tx: painful sx of depression or diabetic neuropathy pain
poop-out syndrome
relapse
patients take SSRI/SNRI’s Have an initial response, continue taking the medication but then experience this
SNRIs AE
induced bipolar state
agitation, activation
Bupropion
wellbutrin
NDRI
TX craving of nicotine (smoking cessation), hypersomnia (>10hrs/nite), ADHD
NOT x anxiety disorder
CAE - Seizures (.4 - 4% at high doses)
NO sexual dysfunction
DEC or not change weight
Onset of action
2-4 weeks
NaSSA
Noradrenergic and Specific Serotonergic Agent
MOA - pre-synaptic alpha 2 adrenergic antagonist
Dec GI side effects from SSRI/Venlafaxine
Mirtazepine
remeron
NaSSA class
AE - weight gain
Mirtazapine + MAO-I
at same time or within 2 weeks INC risk Serotonin Syndrome
Onset of therapeutic effect on insomnia and anxiety
almost immediately
Nortriptyline
pamelor
TCA
secondary amine
(metabolized from tertiary amitriptyline)
2nd line - smoking cessation (bc AE)
TCAs AE
ANTI-cholinergic - BV, urinary hesitancy, dry mouth, constipation
ANTI -a-adrenergic-1 - dizzy, sedation, hypotension
ANTI- Histamine (H1) - sedation, weight gain
Block Na channels - cardiac arrhythmia :(
Desipramine
norpramin
TCA
secondary amine
(metabolized from tertiary imipramine)
TCAs better than SSRI in?
tx depression in men
CYP450 INhibitors
INC TCA’s concentration
Bupropion
Duloxetine
Fluoxetine
Paroxetine
